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Inequalities in social classes for morbidity and mortality exist for occupational class and other important socioeconomic indicators, for instance educational attainment, individual and household income, and wealth are essential socioeconomic indicators. For the most part, these inequalities follow a hierarchical pattern, referred to as the health inequalities invariance. The health inequalities invariance implies the idea that the lower the social class, the poorer the health. For instance, Americans living under the federal poverty line suffer 54,000 excess deaths per year (about the same number of deaths as automobile accidents); but if the threshold for comparison is changed to the wealthiest 20% of Americans versus the bottom 80% of Americans, this difference increases to 361,000 annual deaths (more than any other presently known risk factor).[2] Each socioeconomic indicator represents general and particular parts of what makes up the concept of social class. Thus, socioeconomic indicators cannot be ranked according to the impact they have on social class inequalities in health. Moreover, a person’s social class becomes more easily defined through out there life, because education is accomplished first, which contributes to occupational class, and together these two factors contribute to income. As a result, multiple socioeconomic factors form the overall social class inequalities in health, together [3].

Social mobility health can directly or indirectly contribute to social class positions. In addition, the natural selection explanation assumes that people are taken into particular social classes based on their inherited health, thus making some health inequalities unpreventable. The social selection explanation assumes that some social factors, for example parental social class, may factor into a person’s health and social class. Social selection may also add to the production of health inequalities, such as a disabled person being discriminated in the labor market, causing him/her to descend down the social ladder [5].

Poor living conditions as a child may also have consequences for later life health inequalities. For instance, the effects of a child living in poverty, both through material living conditions and psychological living conditions, may play a role in causing adult health inequalities. Also, poor living conditions as an adult, such as poor housing, poor work conditions, and a lack of resources, can cause health inequalities between social classes. Furthermore, poor psychological living conditions as an adult, for instance stress and having limited social contacts and support, can also cause health inequalities among social classes[6].

Poor health behaviors among the lower social class cause health inequalities. These types of poor health behaviors include smoking, excessive drinking, not exercising, and an unhealthy diet. Smoking in particular is an important health-compromising behavior that probably accounts for a large part of inequalities in morbidity and mortality[7].

There are some topics that need to be addressed in order to reduce social inequalities in health. First, although poverty is a cause of health inequalities, we need to stop associating poverty with social class. Accidents also cause health inequalities, because accidents at home and the workplace tend to occur more in the lower class. Therefore, safety at home and work needs to be addressed, in addition to risk taking behavior. Also, attitudes need to be changed. This is because lower class people need to behave in ways that benefit them, not the way their peers or certain celebrities do. This can best be exemplified by despite their friends and celebrities smoking, they do not [9].

Reducing social class inequalities in health still remains largely an open question. However there are even more steps that can be made. Because health inequalities are deeply inherent, prevention of health inequalities should be initiated early in life. Through promoting equality in society, for instance encouraging equal opportunities for education, more resources will most likely be made available for lower classes, including more equality in health. Health and welfare policies need to be created to encourage these ideas. In addition, there needs to be more promoting, especially among the lower classes, for better living and working conditions. Members of the lower classes also need to improve their health behaviors. Furthermore, there needs to be less discrimination against people with poor health and disabilities, in order to reduce health inequalities between upper and lower classes [10].